Remote Oncology AR Specialist - High-Dollar Claims Expert

MedHQ, LLC; Wichita (KS); Remote; USD 55,000 - 75,000; Full time

Job summary

MedHQ, LLC is seeking an Oncology AR Representative to ensure timely follow-up and collection of outstanding insurance balances for oncology services. The role requires strong knowledge of oncology billing, including drug administration and complex payer requirements, with an emphasis on timely filing and denial resolution.

The ideal candidate will work independently, prioritize accounts by aging and denial risk, and collaborate with billing, coding, and clinical staff to resolve root-cause

Qualifications

• Minimum of 2 years of healthcare AR follow-up or denial management experience.
• Medical Oncology AR experience is required.
• Direct experience with medical oncology billing, insurance follow-up, and denial resolution.
• Working knowledge of CPT, HCPCS, ICD-10, revenue codes, modifiers, and CMS-1500/UB-04 claim forms.
• Familiarity with EOB/ERA/835 remittance interpretation and CARC/RARC denial codes.
• Understanding of payer authorization, medical necessity, and appeal processes.
• Experience with the Medisoft EHR billing system and payer portals.
• Proficiency in Excel and Microsoft Office.

Responsibilities

• Work assigned AR work queues and aged accounts for medical oncology, infusion, and radiation oncology, prioritizing by aging, timely filing deadlines, and denial risk.
• Follow up with commercial, Medicare, Medicare Advantage, and Medicaid payers to determine claim status and secure payment.
• Analyze and resolve oncology-related denials, including medical necessity, authorization and referral, coding and modifier edits, bundling, and drug billing discrepancies.
• Review claims for accurate HCPCS/J-codes, NDC reporting, units of service, and JW/JZ modifier requirements for drug waste.
• Verify that billed chemotherapy and infusion administration codes are supported and sequenced properly.
• Identify and appeal underpayments by comparing remittances to contract terms and fee schedules, including drug reimbursement methodologies.
• Prepare and submit clean, well-supported appeals, including medical records, letters of medical necessity, and peer-to-peer requests when required.
• Coordinate with prior authorization, coding, charge entry, and clinical staff to resolve root-cause issues and prevent repeat denials.
• Handle clinical trial and research-related billing questions in coordination with the designated billing compliance contact.
• Post accurate, detailed account notes for every interaction, including payer reference numbers, contact names, and next action dates.
• Process refunds, adjustments, and write-off requests according to policy and approval thresholds.
• Escalate trends, payer issues, and system or workflow problems to the AR Manager with supporting examples.
• Meet or exceed daily productivity, quality, and cash collection targets.

Skills

Oncology AR experience

Denial management

Payer follow-up

CPT/HCPCS coding

Excel & MS Office

Education

High school diploma or equivalent

Tools

Medisoft EHR

Job description

MedHQ, LLC is seeking an Oncology AR Representative to ensure timely follow-up and collection of outstanding insurance balances for oncology services. The role requires strong knowledge of oncology billing, including drug administration and complex payer requirements, with an emphasis on timely filing and denial resolution.

The ideal candidate will work independently, prioritize accounts by aging and denial risk, and collaborate with billing, coding, and clinical staff to resolve root-cause